The Importance of Snake Education on Snake Conservation

Human activities negatively impact snakes around the world, causing populations to decline and threatening hundreds of snake species with extinction. Snakes serve a valuable role, benefitting both humans and their ecosystems as a whole, and widespread snake extinction would cause negative cascading effects on the rest of the biosphere. However, humans typically perceive snakes with fear and disgust, making it difficult to generate support for snake conservation efforts. Snake education programs can help change people’s attitudes towards snakes, especially if those programs allow people to physically interact with live snakes. Even people who claimed to be afraid of snakes experienced a decrease in fear and increase in positive emotions. The resulting change in attitude increases people’s willingness to conserve snake populations, a shift that will help protect the health of ecosystems around the globe. A snake-centered lesson plan targeted for high school biology teachers to implement in their classrooms can be the start to widespread snake education, enabling the next generation of students to grow up with compassion towards snakes and a willingness to protect them from the impacts of human activities

The interdependence of modality and Theory of Mind

Modality is traditionally defined as the expression of possibility or necessity. In English, modality is expressed by the modal auxiliaries such as can, would, should, or might; adjectives and adverbs such as possible, necessary, maybe, and absolutely; or phrasal verbs such as going to or have to. Theory of Mind (ToM) is broadly defined as the ability to attribute thoughts and beliefs to other people. ToM is usually expressed using propositional attitude verbs such as think as in Mary thinks that it will rain. Hegarty (2006, 2010) proposes that propositional attitude verbs are covertly modalized and can be analyzed using the same apparatus as modals. If this theory is correct, then attitude ascriptions that are used to express ToM should be acquired by children after the child has a command of modality. Previous research shows that modality emerges in children as young as two years of age (Choi, 1999), but that children do not reach adult proficiency until around twelve years of age (Coates, 1987). Similarly, ToM begins to emerge when children can pass the standard false belief task near their fourth birthday (Wimmer & Perner, 1983; Baron-Cohen, Leslie & Frith, 1985), but children lack the necessary interpretation of the thoughts and beliefs of other people until they are approximately twelve years old (Lalonde & Chandler, 2002). This study evaluates the acquisition of both modality and ToM in eighty-six first, third, and fifth graders, using elicitation tasks for modality and question-answer tasks to test for higher-order ToM. The data was then analyzed indicating the approximate age of the acquisition of different types of modality such as epistemic (both strong and weak), alethic, priority, and dynamic. These results were then compared to those of the ToM tasks which indicate the age at which first, second, third, and fourth order ToM are acquired. The data suggests that modality and ToM are interdependent. Based on the results, a strong sense of modality emerges before the appropriate use of expressions of the second-order ToM, and third and fourth order ToM are mastered before the more difficult expressions of modality

The topography of syntactic islands

The Adjunct Island Constraint proposed by Ross (1967) together with Chomsky’s Barriers (1986) are not sufficient to account for the ungrammaticality of wh-extraction out of adjunct clauses, nor do they address the instances of grammatical extraction out of such constructions. Extraction out of Adjunct Islands is now completely predictable using a combination of Chomsky’s Minimalist Program (1995) and Kehler’s Coherence Theory (2002). The combination of these two theories gives an account of both the grammatical and ungrammatical instances of wh- extraction out of adjuncts. The principles of the Minimalist Program together with evidence from Old English adverbial clauses determines the necessary structure for grammatical extraction, while an extension of the Coherence Theory mandates the required semantic relation between the matrix and adjunct clauses. This thesis proves that the possibility of wh-extraction out of adjunct islands is dependent upon the seamless integration of syntax and semantics

Readmission Rates of Patients Discharged against Medical Advice: A Matched Cohort Study

OBJECTIVE: We compared the readmission rates and the pattern of readmission among patients discharged against medical advice (AMA) to control patients discharged with approval over a one-year follow-up period. METHODS: A retrospective matched-cohort study of 656 patients(328 were discharged AMA) who were followed for one year after their initial hospitalization at an urban university-affiliated teaching hospital in Vancouver, Canada that serves a population with high prevalence of addiction and psychiatric disorders. Multivariate conditional logistic regression was used to examine the independent association of discharge AMA on 14-day related diagnosis hospital readmission. We fit a multivariate conditional negative binomial regression model to examine the readmission frequency ratio between the AMA and non-AMA group. PRINCIPAL FINDINGS: AMA patients were more likely to be homeless (32.3% vs. 11%) and have co-morbid conditions such as psychiatric illnesses, injection drug use, HIV, hepatitis C and previous gastrointestinal bleeding. Patients discharged AMA were more likely to be readmitted: 25.6% vs. 3.4%, p<0.001 by day 14. The AMA group were more likely to be readmitted within 14 days with a related diagnosis than the non-AMA group (Adjusted Odds Ratio 12.0; 95% Confidence Interval [CI]: 3.7-38.9). Patients who left AMA were more likely to be readmitted multiple times at one year compared to the non-AMA group (adjusted frequency ratio 1.6; 95% CI: 1.3-2.0). There was also higher all-cause in-hospital mortality during the 12-month follow-up in the AMA group compared to non-AMA group (6.7% vs. 2.4%, p = 0.01). CONCLUSIONS: Patients discharged AMA were more likely to be homeless and have multiple co-morbid conditions. At one year follow-up, the AMA group had higher readmission rates, were predisposed to multiple readmissions and had a higher in-hospital mortality. Interventions to reduce discharges AMA in high-risk groups need to be developed and tested

Voting with their feet - predictors of discharge against medical advice in Aboriginal and non-Aboriginal ischaemic heart disease inpatients in Western Australia: an analytic study using data linkage

Background: Discharge Against Medical Advice (DAMA) from hospital is associated with adverse outcomes and is considered an indicator of the responsiveness of hospitals to the needs of Aboriginal and Torres Strait Islander Australians, the indigenous people of Australia. We investigated demographic and clinical factors that predict DAMA in patients experiencing their first-ever inpatient admission for ischaemic heart disease (IHD). The study focuse sparticularly on the differences in the risk of DAMA in Aboriginal and non-Aboriginal patients while also investigating other factors in their own right. Methods: A cross-sectional analytical study was undertaken using linked hospital and mortality data with complete coverage of Western Australia. Participants included all first-ever IHD inpatients (aged 25–79 years) admitted between 2005 and 2009, selected after a 15-year clearance period and who were discharged alive. The main outcome measure was DAMA as reflected in the hospital record. Multiple logistic regression was used to determine disparities in DAMA between Aboriginal and non-Aboriginal patients, adjusting for a range of demographic and clinical factors, including comorbidity based on 5-year hospitalization history. A series of additional models were run on subgroups of the cohort to refine the analysis. Ethics approval was granted by the WA Human Research and the WA Aboriginal Health Ethics Committees.Results: Aboriginal patients comprised 4.3% of the cohort of 37,304 IHD patients and 23% of the 224 DAMAs. Emergency admission (OR=5.9, 95% CI 2.9-12.2), alcohol admission history (alcohol-related OR=2.9, 95% CI 2.0-4.2) and Aboriginality (OR 2.3, 95% CI 1.5-3.5) were the strongest predictors of DAMA in the multivariate model. Patients living in rural areas while attending non-metropolitan hospitals had a 50% higher risk of DAMA than those living and hospitalised in metropolitan areas. There was consistency in the ORs for Aboriginality in the different multivariate models using restricted sub-cohorts and different Aboriginal identifiers. Sex, IHD diagnosis type and co-morbidity scores imparted different risks in Aboriginal versus non-Aboriginal patients. Conclusions: Understanding the risks and reasons for DAMA is important for health system policy and proactive management of those at risk of DAMA. Improving care to prevent DAMA should target unplanned admissions, rural hospitals and young men, Aboriginal people and those with alcohol and mental health comorbidities

Artificial intelligence, ethics, and hospital medicine: Addressing challenges to ethical norms and patient-centered care

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